A 2-year-old patient had right ocular esotropia for 1.5 years. Right fundoscopyrevealed a large disc, central glial tuft (arrow), and a halo of pigmentary changes in the peripapillary area surrounding the nerve (arrowhead) consistent with methylglycinediacetic acid (MGDA) (Figure 1A). Funnel-shaped morphology of the optic disc (black arrow), adjacent retinal surface elevation and enhancement (red arrow), and irregular thickening of the nerve (blue arrowheads) were detected (Figure 1B, Figure 1C). Irregular thickness of optic nerve occurs in 89% MGDA, the nature being uncertain^(1-3).

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Submitted for publication: December 3, 2024.
Accepted for publication: January 16, 2025.

Funding: This study received no specific financial support.

Disclosure of potential conflicts of interest: The authors declare no potential conflicts of interest.